The Economic Burden Of Inappropriate Patients Who Took Part In New Rural Cooperative Medical System

PurposeOn the basis of comprehensive understanding of the inappropriate admission betweencounty and township government institution. Through the systematic analysis of theexpenditure pattern and economic burden for patients and NCMS funds and social. So that,we can establish the economic burden cost calculation model. To improve the ability offunds management and enhance the risk consciousness so that the NCNS governmentinstitution timely adjust and improve relevant policies. According to specific regionalcharacteristics, to use health resources rationally and effective, so as to controlunreasonable hospital and to reduce the economic burden of stakeholders.Methods(1) Literature research: Relative literatures on inappropriate hospital and economicburden and NCNS were collected through academic journals domestically and abroad. Thechoice of Domestic literature database is given priority to WanFang database and Chineseperiodical net. Foreign literature mainly about the database of Pubmed. Aimed at acomprehensive understanding of economic burden calculation and theory and the influencefactors which related to inappropriate hospital.(2) Typical region field research: According to the level of economic development andgeographical environment, comprehensive consideration of hospitalization health serviceutilization about county and township medical institutions. According to the statistics ofpatient flow, adopt the method of stratified cluster sampling to find3000patientshospitalized cases who participate in NCMS in hubei province.(3) Statistics method: The databases were established and data were inputted into thecomputer by SPSS13.0.The data were analyzed through description statistics, factoranalysis, multivariate logistic regression and linear regression analysis.Results(1) The respectively inappropriate admission rate is12.57%,7.79%and9.11%respectively of the Area A, B, C. The distinction of inappropriate admission rate in threearea is bigger. The major influencing factors of inappropriate admission is sex, maritalstatus (married\widowed) and hospitalization days. (2) Expended and inspection is the main part of the inappropriate admission fee.The proportion of total expended and total case fee is73.63%,66.02%and56.77%. Theproportion of total inspection and total case fee is65.71%,61.52%and63.63%.(3) In view of the disease, The hospital cost of inappropriate admission is lower thanthe reasonable cases. And upon examination, t he difference with significant.(4) The respectively percentage of per capita total economic burden of area A B Caccounted for three of the average household consumer spending is4.78%3.65%and3.71%. In Medical institutions at the county level, the proportion of unreasonable expenseswhich NCNS bear accounted for the total sample cases is3.92%,2.12%,1.95%. Intownship hospitals, the proportion of unreasonable expenses which NCNS bear accountedfor the total sample cases is6.55%,4.88%,4.64%.(5) The major influencing factors of direct economic burden are the level of hospitaland hospitalization days.The major influencing factors of indirect economic burden areper capita income, level of hospital, delay days. The major influencing factors of Totaleconomic burden are the hospitalization days, the level of hospital, delay days, per capitaincome.ConclusionsFormulate hospital management planning and strengthening external constraint, andearnestly solve the interests problem of inappropriate admission behind the driver. Tostrengthen the construction of grassroots medical institutions and outpatient servicecapability. Establish service mode which on the layer classification o f the hospital. Meetdifferent levels of patients with medical needs. Strengthen the standardization training ofdisease classification for the doctors, raise the level of the doctor’s business andprofessional ethics. Strict medical establishment that decide a dot which decides theintroduction,the exit and competition mechanism, to strengthen the performancemanagement for the orgnaization of NCMS. Only effectively solve the problem of theinterests of all parties, inappropriate admission rate may reduce, the efficiency of NCMSfunds will improve and the peasants’ economic burden will reduce.